Archive for Crohn’s disease
Study Suggests Environmental Factors Play a Causative Role in IBD
Now that at least a portion of mainstream medicine is beginning to recognize the role that environment plays in many diseases, we need to take a more aggressive role in managing these conditions without the use of drugs or surgery. Crohn’s disease and ulcerative colitis in this study were found to occur at higher rates in spouses of patients with the disease that would otherwise have been expected. Patient with IBD can actually respond very well to functional medicine concepts such as restoration of GI environment, avoidance of food allergens and maintenance of optimal digestive functioning.
Gastroenterology — Abstracts: LAHARIE et al. 120 (4): 816
Cutaneous Disorders in Crohn’s Disease Respond to Infliximab
This article supports things I’ve said for awhile now. Many chronic autoimmune conditions may actually come from the same basic metabolic defect, and that the ultimate manifestation of a certain disease is just a branch along the changes caused by the original defect. We are now seeing a drug (infliximab, a drug that blocks TNF alpha from doing it’s job) that is having an effect of rheumatoid arthritis, Crohn’s disease and now several autoimmune skin disorders as well. Before we get too excited here that the answer has been found, remember that TNF alpha is needed for healthy immune function and cancer prevention. I am sure that the long term use of these drugs will produce higher rates of certain types of cancer. Lowering levels of TNF naturally included weight loss, maintaining insulin sensitivity and leaning towards a plant based diet. Improvement of Pyoderma Gangrenosum and Psoriasis Associated With Crohn Disease With Anti-Tumor Necrosis Factor alpha Monocl
Mucosal TNF-alpha production in Crohn’s disease downregulated by probiotic bacteria
Research articles like this just bring tears to my eyes. Probiotics are showing efficacy and high levels of safety in a wide variety of GI conditions (and their associated systematic manifestations). Like many other natural therapies, however, their use is still rare. Here we see probiotics lowering the amount of inflammation at the mucosal level of the GI tract. Remember, this is similar to what the new class of drugs for Crohns’ and RA do–the drugs block the effect of TNF-alpha. What still surprises me is that, despite all the research on the benefits of probiotics, we still view antibiotic resistance as the major concern with rampant antibitotic use. I have always considered the destruction of natural flora as the most important bad side effect…
Gut — Abstracts: Borruel et al. 51 (5): 659
Hyperketonemia Increases Tumor Necrosis Factor-alpha Secretion
If you are a regular reader of Updates, I’m sure you’re aware of just how much I support the high protein diets that are designed to throw the human body into that dangerous state called ketosis. Here is further support against the “health improving” high protein diets…ketosis leads to upregulation of TNF-alpha, a cytokine intimately related in turning up the level of inflammation in the body. Consider that the latest and greatest drugs for rheumatoid arthritis and Crohn’s disease are TNF blockers because increased TNF-alpha is believed to be a contributing factor to the perpetuation of these chronic inflammatory diseases.
Epidemiology and natural history of Crohn’s disease
This is a numbers study that shows how poorly this disease is managed currently. 57% of patients will require resection (removal of a portion of small intestine). With all the knowledge out there about functional bowel disorders, it is frankly just short of shocking that management is not better. We have the tools, why not use them? In my experience, many of the Crohn’s patients I’ve seen have overgrowth of yeast. Control the sugars in the diet, load them up with probiotics and a diet that promotes growth of healthy flora will put most Crohn’s cases into remission.
Antibiotic use and the development of Crohn’s disease
Refer back to my ranting and raving at the beginning of this update. It doesn’t take too much to follow the physiology: antibiotic destroys normal flora, pathogenic bacteria and yeast coupled with the loss of our gut’s protective mechanism leads to overall increased inflammation in the gut. Gut — Abstracts: Card et al. 53 (2): 246 -
High prevalence of Mycobacterium avium subspecies paratuberculosisIS900 DNA in gut tissues from individuals with Crohn’s disease
While I am not familiar with this specific subspecies, the fact that this mycobacterium (mycobacterium is the type of bug that causes TB) was seen with high prevalence in Crohn’s does not surprise me (not finding it in ulcerative colitis, however, was a little surprising…). We have long known that the gastrointestinal flora plays a role in the health of the GI tract and that autoimmunity can be induced by a poor bacterial balance.
However, the approach remains the same–methods to lower the number of undesirable bugs and increase the presence and growth of probiotic flora.
Clinical, microbiological, and immunological effects of fructo-oligosaccharide in patients with Crohn’s disease
For as much research as there is supporting the role of healthy microbial flora in the development and treatment of IBD, it continues to amaze me that I have yet to have a patient come through my office w/ IBD that was given the slightest bit of information from their GI specialist on the effect of a healthy GI flora.
I even had a patient come in a few weeks ago that had a colonoscopy done and they found some ulcerative lesions, but not enough for a full diagnosis of UC. The approach? Watch and wait. The concept that prevention may be a good idea didn’t enter into the picture.
Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn’s disease
It is strange that two of strongest markers to predict relapse are tests most GI docs have probably never heard of. Altered GI permeability (“leaky gut”) as evidenced by a lactulose/mannitol challenge is another strong predictor of relapse.
The nice thing is that these markers can be easily checked and modified with natural approaches such as omega-3 fatty acids, non-processed diets and probiotic supplementation.
High dose probiotic and prebiotic cotherapy for remission induction of active Crohn’s disease
While this is a small study, it’s definitely an important one for a variety of reasons. First, much research suggests that altered bacterial flora plays almost the pivotal role in development of inflammatory bowel disease, but that this alteration occurs early in life. All the more reason to avoid antibiotics at all costs, especially in infants.
Next, the levels used in this study were substantial, with the average being 45 billion CFUs for the entire 13 months of the study. Lastly, the response was quite strong, with NO side effects noted. Given the litany of problems associated with pharmaceutical treatment of IBD, this lack of side effects is a strong selling point.